If the recent debate over fixing the U.S. healthcare system has done anything, it has helped to reveal some of the complexities underlying the delivery of cost-efficient, high-quality, patient-focused care. For learning professionals at hospitals and other healthcare organizations, this translates into myriad issues, including addressing current and projected shortages of doctors and nurses, improving the quality of care and patient outcomes, focusing on safety for patients and providers, and driving excellent performance across the board.
Without a doubt, training and development is central to meeting these goals, and healthcare organizations are answering the call through initiatives that develop leaders, pinpoint high-potential future successors, and deliver training in ways that suit the healthcare environment.
Who will watch the store?
The projected shortage of U.S. healthcare workers has been well-documented, with the Association of Medical Colleges citing a 124,000 to 159,000 physician shortfall by 2025. Along the same lines, recent data published in the journal Health Affairs predicts a 260,000 shortage of registered nurses (RNs) by the year 2025. (Data from that same article, however, indicates a potential upturn in the number of active RNs, as younger professionals surge into the workforce and RNs age 50 and above are retained among the ranks due to a number of factors - most prominently, a weak economy.)
These numbers overlap with numerous other challenges within the healthcare field. Chief among these is the fact that the overall American population is aging rapidly and will soon represent roughly 20 percent of people living in the United States. Members of this demographic group, as they move into their 60s, are likely to meet what the Institute of Medicine calls "a health care workforce that is too small and critically unprepared to meet their health needs."
Additionally, the U.S. Census Bureau predicts that nearly a third of active physicians will be over the age of 55 by 2020, and other data indicate that more than 35 percent of RNs will be between the ages of 50 and 64 years by 2015. Additionally, the National Center for Healthcare Leadership has spelled out the difficulty in attracting younger professionals to healthcare management. So the mission to retain the vast knowledge and experience of older administrators, RNs, and physicians will become increasingly critical as these professionals inch closer to retirement. This also helps to sound the alarm for upskilling the current workforce and finding innovative means to keep learning a top priority.
Lastly, there is the ongoing move for all healthcare providers to strengthen care quality and patient service. Taking steps to develop leaders, groom successors for key positions, and identify future leaders early has become particularly crucial. Leaders provide the guiding vision, passion, and integrity so important to the overarching goal of providing care and service that is safe, secure, and successful in terms of outcomes. In other words, current leaders and well-primed successors have a place on the front lines of achieving strategic healthcare goals.
Healthcare is different from most other industries, because patient privacy and HIPAA regulations challenge learning organizations in hospitals and clinics to discover innovative ways to deliver learning to their employees.
Jeanne Bonzon, director of learning and development at BEST Award - winning BJC HealthCare in St. Louis, underscores the importance of boosting employees' skills, while offering convenient, safe, digital delivery. Interestingly, despite the IT constraints of healthcare organizations, it has been reported that healthcare is projected to see the most growth across industries in use of e-learning over the next five years. Bonzon's organization is certainly a testament to this as BJC has heeded the call to train employees on tasks from fundamental computer skills to annually mandated courses such as environmental health and safety, all online or via podcast or other mobile delivery format.
Bonzon points out the geographical and timing issues that further necessitate online learning delivery versus classroom-based training. BJC has even designed delivery tools that offer employees at outlying hospitals the opportunity to take part in courses via video conference. They have designed classes in medical terminology and have most recently been asked to offer training on medical billing and coding via mobile devices. The health system also offers online communities of practice via its LMS as more of a "pull" learning initiative. These highly flexible delivery tools are important to a healthcare staff that operates seven days a week, in round-the-clock shifts.
Supporting leaders and successors
The Journal of Health Administration Education reported in 2004 that 75 percent of hospitals do not have succession planning initiatives. The learning organization at San Antonio - based University Health System is glad to be in the minority. Their strategic leadership and succession planning initiatives not only provide the rigor needed to build a strong pipeline for talent, but they go beyond planning for the C-suite alone.
"In our world, it has to do with how structured the leadership development efforts are. Everything we do is highly structured," says Administrative Director Jacque Burandt. So each grouping within its Institute for Leaders, from the Performance Leadership Academy (director level), to the Management Development Academy (team leaders, supervisors, managers, charge nurses, and patient care coordinators), to the Leadership Academy for Physicians, takes a competency-based, highly focused approach to the curricula.
For example, in developing the Leadership Academy for Physicians, UHS followed analysis results that demonstrated a need for strengthened skills in strategic planning, improving operations, communication, and financial translation. The academy makes these skills trainings part of the curricula, to help support a physician staff that is already strong in terms of clinical practice skills.
According to Performance and Development Manager Lynn Lindemann, leadership and succession planning "used to be about who you knew and how you were raised up in the company." UHS's structured, multitiered approach to equipping the right people with the right skills at the right time, makes the old ways truly a thing of the past. By creating a well-trained pool of talent throughout a variety of areas, the pipeline for high-level successors is not only maintained, but meaningful for organizationwide strategic success.
The picture of health
Whatever results from the Congressional healthcare debates, changes to the healthcare system are inevitable and ongoing. Developing learning programs to meet or preempt these changes are a priority, and quality will be the yardstick by which their success will be measured. The learning team at UHS is an example of how this relationship between learning and quality takes shape. "Even if all patients eventually gain access to the same high quality of care, the quality of our service will still differentiate us from other providers," says Burandt. "And that's a major part of how we're directing our learning efforts right now." T+D